Individual provider Active NPI

William Benjamin Bleazard, DPT

  • Physical Therapist
  • Eugene, OR
National Provider Identifier
1467659631
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
450 Country Club Rd Ste 325
Eugene, OR 97401-6134
Phone
(541) 345-8895
Fax
(541) 345-8867
NPI assigned
Jun 29, 2007
Last updated
Dec 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X OR Primary

Addresses

Primary practice location

450 Country Club Rd Ste 325
Eugene, OR 97401-6134

Mailing address

450 Country Club Rd Ste 325
Eugene, OR 97401-6134
Phone (541) 345-8895

Other identifiers 1

IdentifierTypeStateIssuer
006506MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070927000109 OR Practitioner - Physical Therapist in Private Practice 2961597604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aligned Physical Therapy LLCGroup PAC ID 3779895677, 2 clinicians

Practice addresses (Care Compare)

450 Country Club Rd
Suite 325
Eugene, OR 97401-6134
Phone (541) 915-3811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aligned Physical Therapy LLC Physical Therapist CurrentSince Jun 20, 2015 Accepting new patients
Comprehensive Physical Therapy, Inc. PastSince May 27, 2003 Accepting new patients

Locations

1603 Oak St
Eugene, OR 97401
Phone (541) 345-8895

450 Country Club Rd
Ste 325
Eugene, OR 97401
Phone (541) 345-8895

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1467659631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 COUNTRY CLUB RD STE 325",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016134",
            "telephone_number": "541-345-8895",
            "fax_number": "541-345-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 COUNTRY CLUB RD STE 325",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016134",
            "telephone_number": "541-345-8895",
            "fax_number": "541-345-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEAZARD",
        "first_name": "WILLIAM",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006506",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.